Comparison of Core Body Temperatures in Patients Administered Remimazolam or Propofol during Robotic-Assisted and Laparoscopic Radical Prostatectomy

Abstract

Background and Objectives: Different types of anesthetics affect thermoregulatory mechanisms, such as the redistribution of body temperature, loss of skin heat, or inhibition of thermoregulatory vasoconstriction. Therefore, we compared remimazolam with propofol in terms of core body temperature in patients undergoing robotic-assisted and laparoscopic radical prostatectomy. Materials and methods: Ninety patients were randomly assigned to either the propofol–remifentanil (PR) group or the remimazolam–remifentanil (RR) group. The PR group (n = 45) received effect-site concentrations of 6.0 μg/mL of propofol and 4 ng/mL of remifentanil, followed by 0.9 mg/kg of 1% rocuronium and maintenance with effect-site concentrations of 2–4 μg/mL of propofol and 3 ng/mL of remifentanil. The RR group (n = 45) received remimazolam 6 mg/kg/h by continuous intravenous infusion and the effect-site concentration of 4 ng/mL of remifentanil, followed by 0.9 mg/kg of 1% rocuronium, remimazolam 1–3 mg/kg/h, and remifentanil 3 ng/mL. The primary outcome was core body temperature, and secondary outcomes included vasoconstriction threshold (°C) and time to onset of vasoconstriction (min). Results: The core body temperature in the RR group was significantly higher at 60, 80, 100, 120, 140, 160, and 180 min after induction than in the PR group (p < 0.01). The vasoconstriction threshold was significantly higher in the RR group (35.2 ± 0.4) than in the PR group (34.8 ± 0.3) (p < 0.01). The time to onset of vasoconstriction was significantly less in the RR group (150.5 ± 10.2) than in the PR group (158.5 ± 8.4) (p < 0.01). However, the incidence of intraoperative hypothermia was not significant between two groups. Conclusions: Remimazolam appears to reduce vasoconstriction threshold less than and had a faster onset of vasoconstriction, resulting in superior thermoregulatory control.

Effect of Remimazolam on Pain Perception and Opioid-Induced Hyperalgesia in Patients Undergoing Laparoscopic Urologic Surgery—A Prospective, Randomized, Controlled Study

“…When it comes to temperature regulation including hypothermia and PAS, remimazolam had more favorable outcomes than propofol or sevoflurane [17,18]. Group RHR had a significantly lower incidence of both intraoperative and postoperative hypothermia compared with groups DHR and DLR.…”

Remimazolam and serious adverse events

“…Adverse events of remimazolam 845 34 UK Endoscopy Sedation 100 0% Cao 35 China Endoscopy Sedation 74 4% Hypotension Cao 36 China Endoscopy Sedation 19 0% Chae 128 Korea All kinds Anaesthesia 120 0% Chen 37 China Clinical study Sedation 87 0% Chen 38 China Endoscopy Sedation 189 13% Hypotension Chen 39 China Bronchoscopy Sedation 73 12% Hypotension Chen 40 China Endoscopy Sedation 196 24% Hypotension Chen 41 China Clinical study Sedation 83 0% Choi 42 Korea ENT Anaesthesia 70 26% Hypotension Choi 43 Korea LMA insertion Anaesthesia 40 0% Dai 44 China All kinds Anaesthesia 141 23% Hypotension Deng 45 China Orthopaedic Sedation 37 4 Hypotension Doi 46 Japan All kinds Anaesthesia 300 24% Hypotension, delayed emergence Doi 47 Japan All kinds Anaesthesia 67 31% Hypotension, delayed emergence Gao 48 China Bronchoscopy Sedation 60 27% Hypotension Guan 49 China Curettage Sedation 70 6% Hypotension Guo 50 China Oral surgery Sedation 20 5% Hypotension Guo 51 China Endoscopy Sedation 39 15% Hypotension Hari 52 Japan Laparoscopy Anaesthesia 30 0% Hu 53 China Endoscopy Sedation 173 32% Hypotension Ichijima 54 Japan Endoscopy Sedation 20 0% Jia 55 China Bronchoscopy Sedation 50 0% Jiang 56 China Urologic Anaesthesia 75 6% Hypotension Kaneko 57 Japan Cardiac Anaesthesia 40 0% Kleiman 58 Germany Clinical study Sedation 20 0% Lee 59 Korea Urologic Anaesthesia 45 0% Lee 60 Korea Laparoscopy Anaesthesia 64 3% Re-sedation Li 61 China Nerve Block Sedation 60 0% Liu 62 China Endoscopy Sedation 50 0% Liu 63 China Cardiac Anaesthesia 30 17% Hypotension Liu 64 China Endoscopy Sedation 115 13% Hypotension Lu 65 China Endoscopy Sedation 53 0% Lu 66 China Endoscopy Sedation 200 ...…”